Complete upper airway collapse and apnoea during tethered swimming in horses

Description and Analysis of Horse Swimming Strategies in a U-Shaped Pool

Aquatic training has been integrated into equine rehabilitation and training programs for several decades. While the cardiovascular effects of this training have been explored in previous studies, limited research exists on the locomotor patterns exhibited during the swimming cycle. This study aimed to analyze three distinct swimming strategies, identified by veterinarians, based on the propulsion phases of each limb: (S1) two-beat cycle with lateral overlap, (S2) two-beat cycle with diagonal overlap, and (S3) four-beat cycle. 125 underwater videos from eleven horses accustomed to swimming were examined to quantify the differences in locomotor patterns between these strategies. Initially, a classifier was developed to categorize 125 video segments into four groups (CatA to CatD). The results demonstrated that these categories correspond to specific swimming strategies, with CatA aligning with S1, CatB with S2, and CatC and CatD representing variations of S3. This classification highlights that two key parameters, lateral and diagonal ratios, are indeed effective in distinguishing between the different swimming strategies. Additionally, coordination patterns were analyzed in relation to these swimming strategies. One of the primary findings is the variability in swimming strategies both within and between individual horses. While five horses consistently maintained the same strategy throughout their swimming sessions, six others exhibited variations in their strategy between laps. This suggests that factors such as swimming direction, pauses between laps, and fatigue may influence the selection of swimming strategy. This study offers new insights into the locomotor patterns of horses during aquatic training and has implications for enhancing the design of rehabilitation protocols.

Workload and spirometry associated with untethered swimming in horses

BACKGROUND

Swimming has been used empirically for rehabilitation and conditioning of horses. However, due to challenges imposed by recording physiological parameters in water, the intensity of free swimming effort is unknown.

OBJECTIVES

Measure the physiological workload associated with untethered swimming in horses. Five fit Arabian endurance horses were assessed while swimming in a 100 m-long indoor pool. Horses were equipped with a modified ergospirometry facemask to measure oxygen consumption (V̇O2) and ventilatory parameters (inspired/expired volumes, VI, VE; peak inspiratory/expiratory flows, PkVI, PkVE; respiratory frequency, Rf; minute ventilation, VE; inspiratory/expiratory durations and ratios, tI, tE, tI/ttot, tE/ttot); and an underwater electrocardiogram that recorded heart rate (HR). Postexercise venous blood lactate and ammonia concentrations were measured. Data are reported as median (interquartile ranges).

RESULTS

Horses showed bradypnea (12 breaths/min (10-16)) for the first 30 s of swimming. V̇O2 during swimming was 43.2 ml/(kg.min) (36.0-56.6). Ventilatory parameters were: VI = 16.7 L (15.3-21.8), VE = 14.7 L (12.4-18.9), PkVI = 47.8 L/s (45.8-56.5), PkVE = 55.8 L/s (38.3-72.5), Rf = 31.4 breaths/min (20.0-33.8), VE = 522.9 L/min (414.7-580.0), tI = 0.5 s (0.5-0.6), tE = 1.2 s (1.1-1.6), tI/ttot = 0.3 (0.2-0.4), tE/ttot = 0.7 (0.6-0.8). Expiratory flow tracings showed marked oscillations that coincided with a vibrating expiratory sound. HR was 178.0 bpm (148.5-182.0), lactate = 1.5 mmol/L (1.0-1.9) and ammonia = 41.0 µmol/L (36.5-43.5).

CONCLUSIONS

Free (untethered) swimming represents a submaximal, primarily aerobic exercise in horses. The breathing pattern during swimming is unique, with a relatively longer apneic period at the beginning of the exercise and an inspiratory time less than half that of expiration.

Frequency of cardiac arrhythmias in horses during straight and untethered swimming

BACKGROUND

Cardiac arrhythmias have not been previously reported in horses while swimming.

OBJECTIVES

To describe the type and frequency of encountered arrhythmias during repetitive swimming cycles.

STUDY DESIGN

Descriptive observational study.

METHODS

Sixteen horses swam five pool lengths (75 m), each separated by an active recovery walk. Continuous electrocardiograms (ECGs) were recorded (n = 80) and analysed during the pre-swim, swim and active-recovery periods. Arrhythmias were categorised as sinus arrhythmia (SA), sinus block, sinus pause (compensatory and non-compensatory), second degree atrioventricular block (2AVB) for physiological arrhythmias, supraventricular premature depolarisation (SVPD) and ventricular premature depolarisation (VPD) for non-physiological arrhythmias. A linear mixed-effects model was used to examine the effects of repetitive swim lengths on arrhythmias and swimming parameters. Data were reported as median [interquartile range].

RESULTS

Fifteen horses (94%) experienced at least one arrhythmia; however, the frequency remained low and 2AVB were only observed during the pre-swim period. The swimming heart rate (HR) was 162 bpm [141;173]. Sinus blocks, sinus pauses, SA, SVPD and VPD were all recorded at least once during swimming. Except for one VPD couplet, all premature depolarisations were isolated. During active-recovery, the HR was 105 bpm [103;106], with SA observed in 13 horses (81%), isolated SVPD in six horses (38%), sinus pause in one horse (6%) but no VPD present.

MAIN LIMITATIONS

Limited number of horses precluding population prevalence assessment.

CONCLUSION AND CLINICAL IMPORTANCE

High-quality underwater ECGs were acquired in swimming horses for the first time. The frequency of arrhythmias remained low and rare pathological arrhythmias were observed during repetitive swimming and active-recovery cycles. Swimming with active-recovery periods is not a high-risk cardio-arrhythmic exercise.

Free Swimming and Exercise-Induced Pulmonary Hemorrhage in Endurance Horses: A Preliminary Study

Swimming is used for rehabilitation of musculoskeletal injuries and for conditioning to improve equine fitness. However, there are anecdotal reports that suggest that tethered swimming can induce epistaxis, likely secondary to exercise-induced pulmonary hemorrhage (EIPH). The objective of this observational, prospective study was to investigate if EIPH occurs during intensive free-swimming training sessions (5 × 70m) using 15 endurance horses. On tracheo-bronchoscopic evaluations following swimming, low grade mucus scores were observed, but no tracheal blood was observed. Bronchoalveolar lavage fluid analysis revealed a low cellularity, and the median red blood cell count (RBCs) was 271 cells/μL (interquartile range 150-363 cells/μL), which is much lower than the threshold of RBCs >1,000 cells/μL for horses to be considered positive for EIPH. Therefore, free swimming does not seem to predispose endurance horses to EIPH following a typical free-swimming training session.

Comparison of Effects of an Endotracheal Tube or Facemask on Breathing Pattern and Distribution of Ventilation in Anesthetized Horses

Equine respiratory physiology might be influenced by the presence of an endotracheal tube (ETT). This experimental, randomized cross-over study aimed to compare breathing pattern (BrP) and ventilation distribution in anesthetized horses spontaneously breathing room air via ETT or facemask (MASK). Six healthy adult horses were anesthetized with total intravenous anesthesia (TIVA; xylazine, ketamine, guaiphenesin), breathing spontaneously in right lateral recumbency, and randomly assigned to ETT or MASK for 30 min, followed by the other treatment for an additional 30 min. During a second anesthesia 1 month later, the treatment order was inversed. Electrical impedance tomography (EIT) using a thoracic electrode belt, spirometry, volumetric capnography, esophageal pressure difference (ΔPoes), venous admixture, and laryngoscopy data were recorded over 2 min every 15 min. Breaths were classified as normal or alternate (sigh or crown-like) according to the EIT impedance curve. A mixed linear model was used to test the effect of treatment on continuous outcomes. Cochran-Mantel-Haenszel analysis was used to test for associations between global BrP and treatment. Global BrP was associated with treatment (p = 0.012) with more alternate breaths during ETT. The center of ventilation right-to-left (CoVRL) showed more ventilation in the non-dependent lung during ETT (p = 0.025). The I:E ratio (p = 0.017) and ΔPoes (p < 0.001) were smaller, and peak expiratory flow (p = 0.009) and physiologic dead space (p = 0.034) were larger with ETT. The presence of an ETT alters BrP and shifts ventilation toward the non-dependent lung in spontaneously breathing horses anesthetized with TIVA.